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MARION COUNTY BUILDING INSPECTION <br />SENA?OFt BLDG, NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97801 <br /> <br /> PHONE:588-5147 8:00- 4:30 <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I &rn perf°rnsing w°rk °A a Pr°perrY I °wn °r °ccutSY' <br /> <br />Other .... <br /> <br />DATE: 08/06/92 'fINE: 16:15:03 <br />8ARLOW, THOMAS 'RESIDENTIAL <br /> <br /> 993;4 HILL CREEK RD SE ;8d~"~C~-Cifvl dG-B[ .... !'OCtU~)ANT LOAO: <br />AUMSVILLE OR 97325 HARIO~ COUHTY NO <br /> <br /> SITE NU~BEE: <br />PHONE: 749-1782 VALUATION: <br /> <br />; : NO : NO <br /> <br />TYPE: PLUMBING <br /> <br />CONTRACTOR, NO. <br />BARLOW~ THOMAS <br />SAME <br /> <br />PHONE: 749-1782 <br /> <br /> ITEM <br />WATER LINES, iST 100 FEET <br />WATER LINES, EA. ADDL. 100 FEET <br />PLUHBINQ STATE SURCHARGE <br /> <br />PERHIT OR APPLICATION NO: ?041791 <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />QUANTITY AMOUNT <br />1 $20.00 <br />1 $15.00 <br /> $1.75 <br /> <br />$36.75 <br /> $0.00 <br />$36.75 <br /> <br /> ~.~8A~ANCE OUR $o.00 <br />PAYEE: BARLOW. THOMAS \~'~/ . RECEIPT NO~ 4~836 <br /> <br />* THiS IS 'NOT A PERMIT. THIS APPLICATIONMUST GO THROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWING MUST BE COMPLETED. IT IS THE RESPONSIGILITY OF THE APPLICANT TO ASSURE THAT <br />LL NECESSARY INFORMATION HAS BEEN PROVIDED. <br /> <br />PLAN REVIEW: 8Y ............ DATE ............. <br />REMARKS: ~ATER LINE <br /> <br />CITY JURISOICTION: BY ......... OATE <br /> <br />OFFICE COPY <br /> <br /> <br />